Trigger finger
Definition
Trigger finger is the popular name of stenosing tenosynovitis, a
painful condition in which a finger or thumb locks/snaps when it is
bent (flexed) or straightened (extended).
Description
Tendons are tough, fibrous cords that connect muscles to bones.
Tendons must slide easily through their protective coverings (tendon
sheaths). The finger and thumb bones have tendons that are
responsible for bending and straightening the fingers. Problems
start when a tendon sheath narrows (stenosis) and the outer covering
of the tendon becomes inflamed (tenosynovitis). The tendon swells
because of the constriction, sometimes forming a nodule, and is no
longer able to move smoothly through its sheath. As a result, a
finger may lock in an upward position as the person tries to
straighten it. The condition usually happens in the ring and middle
fingers and is more common in women, typically over age 30. In
infants and small children, the condition generally occurs in the
thumb.
Causes and symptoms
Trigger finger is often an overuse injury because of repetitive or
frequent movement of the fingers. Trigger finger may happen because
a person performs the same manipulation over and over on a job, from
squeezing and gripping during a weekend of heavy pruning and
gardening, or from such hobbies as playing a musical instrument or
crocheting. Trigger finger may also result from trauma or accident.
The symptoms of trigger finger are pain in the fingers and "popping"
sensations. Sometimes the finger may lock down into the palm or lock
out straight. Symptoms are usually worse in the morning and improve
during the day.
Diagnosis
The diagnosis of trigger finger and thumb is obvious on physical
examination. Often there is a click that can be felt as the nodule
passes through the sheath.
Treatment
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Initial treatment for
mild or infrequent symptoms of trigger finger include rest,
avoiding or modifying those activities that caused the
inflammation, and the use of a nonsteroidal anti-inflammatory
drug (NSAID) such as ibuprofen.
-
For mild to moderate
cases Injection of a steroid medication (cortisone) into the
tendon sheath is an option to treat trigger finger.
-
In more severe cases
surgery may be required to relieve the symptoms. A local
anesthetic is used for the surgical procedure performed in the
office. An incision is made by a surgeon in the palm of the hand
at the base of the affected finger or thumb to relieve the
constriction of the tendon. Relief of symptoms is immediate, you
may resume activities to tolerance right away and sutures are
removed in 10 to 14 days.
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